biostudies-literatureMcCune JSAmerican Cancer SocietyNational Cancer InstituteBeckman Research Institute, City of HopeNCI NIH HHSNational Institute of General Medical SciencesNIGMS NIH HHS322-331https://www.ebi.ac.uk/biostudies/studies/S-EPMC10622331biostudies-literatureUnknown30(2)<h4>Introduction</h4>Medication nonadherence continues to be challenging for allogeneic hematopoietic cell transplant (HCT) recipients. The risk and severity of chronic graft-versus-host disease (GVHD) are associated with low immunosuppressant concentrations (which can be improved with model-informed precision dosing (MIPD)) and with immunosuppressant nonadherence (which can be improved with acceptable interventions).<h4>Methods</h4>With the goals of improving adherence and achieving therapeutic concentrations of immunosuppressants to eliminate GVHD, we characterized the feasibility of using the Medication Event Monitoring (MEMS^®) Cap in adult HCT recipients.<h4>Results</h4>Of the 27 participants offered the MEMS^® Cap at the time of hospital discharge, 7 (25.9%) used it, which is below our a priori threshold of 70%. These data suggest the MEMS^® Cap is not feasible for HCT recipients. The MEMS^® Cap data were available for a median of 35 days per participant per medication (range: 7-109 days). The average daily adherence per participant ranged from 0 to 100%; four participants had an average daily adherence of over 80%.<h4>Conclusions</h4>MIPD may be supported by MEMS^® technology to provide the precise time of immunosuppressant self-administration. The MEMS^® Cap was used by only a small percentage (25.9%) of HCT recipients in this pilot study. In accordance with larger studies using less accurate tools to evaluate adherence, immunosuppressant adherence varied from 0% to 100%. Future studies should establish the feasibility and clinical benefit of combining MIPD with newer technology, specifically the MEMS^® Button, which can inform the oncology pharmacist of the time of immunosuppressant self-administration.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersImmunosuppressant adherence in adult outpatient hematopoietic cell transplant recipients.PMC10622331R01 GM129863U01 CA239373U01CA239373P30 CA033572P30CA033572California Institute of Technology – City of HopCity of Hope&apos;s Center for Cancer and AgingRSG-21-181-01-CTPSR01GM129863Shan HMcCune JSArmenian SHMielcarek MGao WNakamura RMager DEKanakry CGfalseImmunosuppressant adherence in adult outpatient hematopoietic cell transplant recipients.<h4>Introduction</h4>Medication nonadherence continues to be challenging for allogeneic hematopoietic cell transplant (HCT) recipients. The risk and severity of chronic graft-versus-host disease (GVHD) are associated with low immunosuppressant concentrations (which can be improved with model-informed precision dosing (MIPD)) and with immunosuppressant nonadherence (which can be improved with acceptable interventions).<h4>Methods</h4>With the goals of improving adherence and achieving therapeutic concentrations of immunosuppressants to eliminate GVHD, we characterized the feasibility of using the Medication Event Monitoring (MEMS^®) Cap in adult HCT recipients.<h4>Results</h4>Of the 27 participants offered the MEMS^® Cap at the time of hospital discharge, 7 (25.9%) used it, which is below our a priori threshold of 70%. These data suggest the MEMS^® Cap is not feasible for HCT recipients. The MEMS^® Cap data were available for a median of 35 days per participant per medication (range: 7-109 days). The average daily adherence per participant ranged from 0 to 100%; four participants had an average daily adherence of over 80%.<h4>Conclusions</h4>MIPD may be supported by MEMS^® technology to provide the precise time of immunosuppressant self-administration. The MEMS^® Cap was used by only a small percentage (25.9%) of HCT recipients in this pilot study. In accordance with larger studies using less accurate tools to evaluate adherence, immunosuppressant adherence varied from 0% to 100%. Future studies should establish the feasibility and clinical benefit of combining MIPD with newer technology, specifically the MEMS^® Button, which can inform the oncology pharmacist of the time of immunosuppressant self-administration.2024-01-01T00:00:00Z2024 Mar2025-04-18T12:52:39.432Z2025-04-06T22:16:16.415ZS-EPMC106223313713419610.1177/10781552231171607